PARAMETRIAL INVASION IN CERVICAL-CARCINOMA - EVALUATION OF DETECTION AT MR-IMAGING WITH FAT-SUPPRESSION

PURPOSE: To evaluate detection of parametrial invasion at magnetic res onance (MR) imaging with fat suppression. MATERIALS AND METHODS: In 35 patients with cancer of the cervix, MR imaging was performed with the following sequences: T2-weighted turbo spin echo (SE), turbo short in version time inversion recovery (STIR), and unenhanced or gadolinium-e nhanced T1-weighted SE with and without excitation-spoiling fat suppre ssion. Images obtained with each sequence were evaluated for parametri al invasion by two blinded radiologists separately, who scored their l evel of diagnostic confidence from 0 to 10 (no confidence to high conf idence). Then, all images were evaluated together and findings were co rrelated with histopathologic findings. RESULTS: No statistically sign ificant differences were found between staging with T2-weighted turbo SE, turbo STIR, and T1-weighted fat-suppressed gadolinium-enhanced SE images. Staging with T1-weighted SE, T1-weighted gadolinium-enhanced S E, and T1-weighted fat-suppressed SE images was significantly worse (P < .05). Diagnostic confidence was lower (P < .001) with T1-weighted g adolinium-enhanced SE and T1-weighted fat-suppressed gadolinium-enhanc ed SE images (5.5 and 6.2 points, respectively) compared to staging wi th T2-weighted turbo SE and turbo STIR images (8.2 and 7.6 points, res pectively). No statistically significantly improvement in staging accu racy was found when all images were evaluated together. Conclusion: In MR diagnosis of parametrial invasion, the addition of fat-suppressed or gadolinium-enhanced MR images did not improve the accuracy with T2- weighted turbo SE images alone.